The association between baseline viral load and long-term risk in patients with COVID-19 in Hong Kong: a territory-wide study.

The association between baseline viral load and long-term risk in patients with COVID-19 in Hong Kong: a territory-wide study.

Publication date: Dec 28, 2024

COVID-19 can increase the long-term risk of multiorgan dysfunction. Few studies investigated the long-term risk in Asian populations or investigated the association between viral load and long-term risk. We aimed to investigate the post-discharge rates of hospitalization and association with baseline viral load in all patients with COVID-19 in Hong Kong. This was a population-based cohort study included all patients with a positive RT-PCR test for SARS-CoV-2 in Hong Kong between January 1st 2020 and August 30th 2020, routinely admitted to public health care facilities for isolation and treatment. Viral Ct values were available in 3433 (85%) of patients. Outcomes of interest included death, cause-specific hospitalizations, and initiation of medication from the Hospital Authority’s territory-wide electronic health records from the Clinical Data Analysis and Reporting System. In total, 4054 people in Hong Kong tested positive for COVID-19 and were admitted to a public health care facility, of whom 167 (4. 1%) were admitted to ICU. During a median follow-up time of 251 (interquartile range 240-279) days, 408 (11. 9%) were hospitalized for any reason and 16 (0. 5%) patients died. After discharge, patients were most often readmitted for respiratory reasons, followed by gastro-intestinal reasons. A higher viral load (lower RT-PCR Ct values) was associated with a higher likelihood of death (Hazard ratio [HR] 5. 86, 95% Confidence interval [CI] 2. 57-13. 33), hospitalization (HR 1. 22, 95%CI 1. 08-1. 39) or hospitalization for cardiovascular disease (HR 12. 78, 95%CI 3. 67-44. 48). Patients with higher viral loads more likely started ACE-inhibitors (HR 1. 37, 95%CI 1. 12-1. 68) and non-opioid analgesics (HR 1. 01, 95%CI 1. 01-1. 23). In a relatively mild COVID-19 population from Hong Kong, the post-acute risk of complications was substantial. Our results highlight that higher viral load predict post-acute complications in patients with relatively mild disease.

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Concepts Keywords
August Adult
Opioid Aged
Pcr Cohort Studies
Viral COVID-19
Female
Hong Kong
Hospitalization
Humans
Male
Middle Aged
Risk Factors
SARS-CoV-2
Viral Load

Semantics

Type Source Name
disease MESH viral load
disease MESH COVID-19
disease MESH death
disease IDO facility
disease MESH cardiovascular disease
disease MESH complications
drug DRUGBANK Coenzyme M
disease MESH death cause
disease MESH infection
disease MESH muscle fatigue
drug DRUGBANK Acetylsalicylic acid
disease IDO history
disease MESH clinical relevance
disease MESH comorbidity
disease MESH ischemic heart disease
disease MESH myocardial infarction
disease MESH stroke
drug DRUGBANK Pentaerythritol tetranitrate
disease MESH atrial fibrillation
disease MESH Dementia
disease MESH Diabetes mellitus
disease MESH Hypertension
disease MESH Obesity
disease MESH Psychosis
disease MESH Substance abuse
drug DRUGBANK Theophylline
disease MESH chest pain
disease MESH infarction
disease IDO host
disease IDO protein
drug DRUGBANK Angiotensin II
disease MESH long COVID
disease MESH syndrome
disease MESH severe acute respiratory syndrome
drug DRUGBANK Famotidine
drug DRUGBANK Serine
disease MESH influenza
disease MESH ischaemic stroke
pathway REACTOME Reproduction

Original Article

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